Tag Archives: NHS

The professional is political

There is little hope in a recent piece on Respiratory Futures from Dr Phil Hammond. He paints a bleak picture of the NHS under the current Conservative government, and crystallises fears that many of us have that things will only get worse post-Brexit.

The NHS is more than a place we go to work: it is a community, a family. Attacks on our family feel personal and hurt deeply. What has disappointed me over the last few years is the lack of anger and action from our community. Doctors in particular seem to take pride in separating politics from professionalism. They refuse to speak up or get involved, maintaining a so called ‘neutral’ position. It is not neutral to stand by as our workforce is decimated by regressive barriers to migration, by a failure to pay nurses a wage they can live on, by a junior doctor contract justified by lies and driving many out of the profession. It is not neutral to watch our patients get sicker and sicker as they struggle to self-manage complex chronic health conditions in inadequate housing, fighting income uncertainty, benefit cuts, poverty, and hunger.

I include myself in this. I have got angry, I have written letters, I have protested with doctors, nurses, and students. But I have not done enough. We must all reflect on our personal and professional responsibilities outside of a narrow interpretation of what our work entails. Healthcare professionals care for people. What can we do to make sure that care is effective, expert, compassionate, and sustainable? I would suggest that we need to get political.

It is heartening to see a few well known names, and a few new faces doing this in both the mainstream and social media. But more of us must shoulder some of the responsibility. We cannot stand by as our non-UK born colleagues are made to feel unwelcome and undervalued. We must challenge the narratives on ‘health tourism’ and constantly cite data on the tiny proportion of the budget this takes up. We must celebrate the expertise of all our staff, from home and abroad, and shout loudly that they need and deserve to be paid well for their intense physical and emotional work. We must shut down any suggestions of blame for individuals who are getting older, having mental health difficulties or are becoming dependant, and we must value care workers by giving them time, money and respect. We must listen to people, hear what they need to self-manage their health, and relinquish some of our power and control to them. We must challenge our representative bodies when they are slow to change, silent in the face of national crises, or out of touch with their members.

We must use our privilege and power, we must speak up, and we must act.

The Future is Red

I spoke to Marie Claire magazine about my vote, and my response to the election result. You can read the full article, including three other women’s responses, here. Below is my section of the article.

Waking up after the last general election and after the Brexit vote I felt a sense of hopelessness, alienation and despair. What kind of country was I living in? This morning things are very different. I have voted Labour for years, but have done so grudgingly on more than one occasion, feeling it was the best choice of a narrow offering. Yesterday I voted enthusiastically for Labour, and for Jeremy Corbyn. I woke up feeling hopeful and excited for a brighter future.

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Living loss

I got to know Joseph * over a number of months. He was first admitted to hospital in April, when his bed overlooked the garden with trees in bud. As Spring turned to Summer he was readmitted, and when Autumn came he watched the leaves change colour and fall. Each time he was admitted he spent more time in hospital and less time at home, and we worried more about whether this admission might be his last.

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Joseph had been diagnosed with Idiopathic Pulmonary Fibrosis, an incurable condition in which the lungs become progressively scarred, leading to breathlessness and functional decline. Like many patients with a chronic disease, he had opted for a coping strategy that focused on living, and trying to forget there was anything wrong. This meant that despite having symptoms for a number of years he had seldom seen a doctor, knew little about his disease or its’ likely trajectory, and had shared very little with his family.

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Parallel lives

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I am immeasurably proud of the NHS: the most successful model of healthcare the world has ever seen. If anyone within my earshot suggests that privatisation would be a step forward they rapidly regret it. But even I sometimes get a wake up call: a stark reminder of the absolute necessity of the NHS, and the horror we may face if the political right’s dream of marketised healthcare is realised.

On a recent shift as the Medical Registrar I received a call from an A&E doctor who wished to discuss a patient who had suffered a stroke. I was surprised as all patients with strokes are channelled into the acute stroke pathway: assessed and treated by a dedicated team and admitted to a specialised unit for consideration of thrombolysis; specialist investigations; and early physio, speech and language therapy. However the A&E doctor explained the situation and I agreed to admit Maria*.

I sat by Maria’s bed in the Medical Assessment Unit, and listened as she told me her story.

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Lonely this Christmas

I love Christmas. But I occasionally find myself in a moment of loneliness in the midst of all the crowds and music and noise. When I see pictures of friends with their newborns, home just in time for Christmas; hear couples conspiring about the perfect present for each other; or catch the refrain of a song and am reminded that no-one is thinking “all I want for Christmas is you” the sparkle loses it’s shine. Being in the ever diminishing demographic of single 30-somethings can be lonely. But these moments are fleeting. I’m soon reminded of how much love surrounds me as my Mum calls to double check when my train is getting in, my brother texts to ask whether vegetarians eat gravy, and my friends email checking who is bringing the Gin at New Year. I know how lucky I am and how full of people my life is, and I was reminded of this on my last day of work before the Christmas holiday.

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Ron* was a patient I had previously met in clinic. He had severe COPD and lung cancer for which he’d opted not to have treatment. He was admitted the week before Christmas with breathlessness and we were treating him for an infective exacerbation of COPD. We were fully staffed and the team had the ward under control so there was time to do what I wish we could do more often: sit and chat.

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Can we find the spirit of ’45 in 2013?

Today marks a defining moment in the history of Britain, but looking around you wouldn’t believe it. Today, April 1st 2013, sees the The Health and Social Care Act (HSCA) come into force.

The death certificate of the NHS, issued by the National Health Action Party

The death certificate of the NHS, issued by the National Health Action Party

Some still believe that those opposed to the HSCA are over-dramatic, reactionary or naive. They will probably dismiss the National Health Action Party as extreme and publicity-seeking as it has issued a death certificate for the NHS, citing the cause of death as the HSCA 2013, with contributing causes including Thatcherism and the failure of New Labour. But it is difficult to see how anything but extreme statements and gestures can capture the attention of the public. Our generation is standing by as the NHS is quietly privatised and I for one am ashamed.

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Discharges in the dead of night

NHS Hospital discharges: thousands claimed to occur overnight

The news this week has been full of horror stories of patients being discharged from hospital in the dead of night. “Where is the compassion?” they cried, “How could they, the supposed caring profession?”  The stories began after The Times discovered, via Freedom of Information requests, that 100 NHS trusts sent 239,233 patients home last year between 11pm and 6am

The immediate response of the press was to paint a picture of an army of ambulance drivers booting out frail 90 year olds; dumping them at their front doors, alone in the dead of night. This dramatic depiction fuelled discussions on various forums and news programmes. The callers on Radio 4s “Any answers” actually made me turn the radio off.

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